| NPI | 1699237511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE HOESTEN Vice President Of Integration 954-675-3088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-05-29 |